Every day activities, such as grocery shopping or filling the car with fuel, are often punctuated with unexpected encounters for her. ‘Nurse…’ echoes a voice, a familiar visage brimming with recognition. A query brims on the edge of their lips, an urgent plea begging for resolution. The essence of their inquiries often trace back to their past – a time spent incarcerated, often as a person of color, where she was their nurse.
Each query varies. It could be related to a medication the nurse once administered during their period of internment, or a craven need for a sympathetic physician unswayed by their tarnished history. Alternatively, they may seek wholly different assistance; à la carte crises that spring from the aftermath of incarceration. The underlying nerve in their inquiries underscores a glaring issue—the inadequacy of essential resources provided to them upon release.
A community nurse from Shelby County Jail observes, ‘Numerous individuals with chronic health conditions are released without a sufficient amount of the necessary supplies.’ Her narrative unfolds a tale of responsibility far transcending the scope of her clinical domain. Over the years, individuals discharged from juvenile and adult corrective facilities across Tennessee have sought her counsel in navigating the rough terrain of their released lives.
The barriers barricading access to health service post-incarceration are numerous, and the severity far from trivial. Research indicates untreated health illnesses and deteriorating health conditions may well amplify the likelihood of these individuals ending up back in penal institutions. However, the transition between incarceration to freedom is dismally littered with stumbling blocks, a fact further exacerbated by state policies.
Lawmakers in Tennessee chose not to utilize federal funds for widening Medicaid’s net to encompass more low-income adults. This decision, part of their response to the 2010 Affordable Care Act, leaves many freshly released individuals flirting with a preposterous predicament – time off the grid offers them the chance to join the 10% of uninsured Tennesseans.
Many among them grapple with incessantly elusive employment, struggling to cling to unreliable jobs or consigned to low-income roles. Compared to their brethren outside the grip of penal past, these individuals are far more likely to be uninsured and lack stable health coverage. A broader nationwide physician insufficiency further inflates the waiting period for specialized care, especially for conditions commonly seen among this demographic.
The prevalence of chronic conditions such as asthma, hepatitis, HIV, type 2 diabetes, as well as mental health disorders such as depression and bipolar disorder, far surpass the rates seen in the general populace. Collectively, these obstacles paint a bleak and often insurmountable image. These trying conditions often drive recently released individuals to the nurse, their known advocate, for guidance.
This nurse, ever vigil, peruses her surroundings, constantly running into those she had once aided behind bars. ‘I often encounter ex-inmates within the community,’ she remarks. Her course of action under such circumstances is prompt and pragmatic. A quick Google search arms her with potential resources, sometimes directing them to health organizations such as ‘Christ Community Health Services.’
In dire situations, she is left with little choice but to redirect them to the nearest emergency room. Guiltily, she laments, ‘I regret not being in a position to provide appropriate assistance out here.’ A struggle not uncommon, as Love’s story illustrates. During his 17-year incarceration in midst of serving a 25-year sentence for drug-related crimes, Love was diagnosed with diabetes.
With the help of prison health workers, Love managed to maintain a reasonable control over his ailment. Misfortune, however, soon caught up with him following his transition to a halfway house post-release. ‘I was essentially living off vending machine food. Burgers, pizzas… attempts to secure a healthier, diabetes-friendly snack such as an apple were often met with dismissive responses. My blood sugar levels started swinging wildly,’ Love reveals his challenging journey to becoming an amputee.
‘His health took a sharp turn south as soon as he stepped back outside’, Portia Moore, founder and CEO of Memphis’s Transitional Reentry Adult Program remarks. She had fetched Love from a Memphis bus station on the day of his release, and was instrumental in facilitating his return to Ohio, his homeland.
DeWayne Hendrix, another face at the Transitional Reentry Adult Program, reveals a worrying trend noticed during his time in Memphis. ‘I disapproved of our practice of providing a 90-day medication supply to the released and wishing them well. Numerous individuals, ineligible for Medicaid after the 90-day period, would intentionally commit offenses to avail healthcare in prisons or jails.’
Wellness becomes a paramount determining factor dictating the odds of their return to criminal activities. Aspects of pre- and post-incarceration healthcare have served as a nucleus during discussions on reform. As researcher Marc Levin explains, ‘There’s a lot to unpack when discussing post-prison healthcare. We’ve looked into continuity of care upon release, availability of prescribed meds, and appointment adherence.’
It becomes painfully apparent that merely extending Medicaid coverage does not address several challenges that persist during transitioning into community care. There arises an urgent requirement for well-designed policies that strengthen reentry success and offer robust support to communities that bear the potential repercussions of such transitions. Dr. Josiah Rich, the co-founder of Brown University’s Center for Health and Justice Transformation, warns against societal attitudes that deprioritize prisoner health, reminding us of the alarming overarching truth—we may not care nearly enough.